WAIVER AND RELEASE OF ALL CLAIMS
Please read this form carefully, and be aware that by participating in this program, you will be waiving and releasing all claims for injuries you or your minor child might sustain arising out of this program. This includes but is not limited to ground transportation in University-owned or contracted vehicles, which could include serious or even mortal injuries and property damage. The Institution neither assumes responsibility nor provides insurance coverage for any such personal injuries or property damage.
As a participant, I recognize that there are certain risks of physical injury and I agree to assume the full risk of any injuries (including death), damages, or loss which I may sustain as a result of my or my minor child’s participation in any and all activities connected with the program.
I agree to waive and relinquish all claims I may have as a result of my or my minor child’s participation in the program against Western Illinois University, its Board of Trustees, its officers, agents, employees and assigns.
I do hereby fully release and discharge Western Illinois University, its Board of Trustees, officers, agents, employees and assigns from any and all claims from injuries (including death), damages, or loss which I or my minor child may have or which may accrue by participating in the program.
I further agree to indemnify, hold harmless and defend Western Illinois University, its Board of Trustees, its officers, agents, employees and assigns from any and all claims resulting from injuries (including death), damages and losses sustained by me arising out of, connected with, or in any way associated with the activities of the program.
I will assume responsibility for any miscellaneous charges associated with my minor child’s loss of University property, such as a room key.
In the event of an emergency, I authorize Western Illinois University officials and its Board of Trustees to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary for my or my minor child’s immediate care and agree that I will be responsible for payment for any and all medical services rendered.
I have read and fully understand the above information. I am authorized to and agree to grant said waiver and release and give permission to secure treatment.